Androgenic Alopecia - Female Androgenic Alopecia

Female Androgenic Alopecia

Female androgenic alopecia more often causes diffuse thinning without hairline recession. Like its male counterpart, the condition rarely leads to total hair loss.

A recently published study comparing monozygotic female twins found a number of factors associated with hair loss in women with varying degrees of statistical certainty, and stratified by pattern. Factors associated with increased temporal hair loss that were statistically significant (p < 0.05) were as follows:

  • more children (p = 0.005)
  • longer sleep duration (p = 0.006)
  • diabetes mellitus (p = 0.008)
  • lack of exercise (p = 0.012)
  • hypertension (p = 0.027)
  • divorce or separation (p = 0.034)
  • multiple marriages (p = 0.040)

Frontal hair loss, like temporal, included hypertension (p = 0.001) and longer sleep duration (p = 0.011) as risk factors, but also included PCOS (p = 0.002), lack of hat use (p = 0.017), smoking (p = 0.021), high income (p = 0.023), diabetes mellitus (p = 0.023), stress (p = 0.034), and multiple marriages (p = 0.043).

Statistically significant causes of vertex hair loss were: lack of sun protection (p = 0.020), less caffeine (p = 0.040), and a history of skin disease (p = 0.048). Higher testosterone levels were associated with increased temporal and vertex hair loss patterns (p < 0.039). Stress, smoking, more children, and a history of hypertension or cancer were associated with increased hair thinning (p < 0.05). It is unknown to what degree factors contributing to female hair loss overlap with those in men. Later studies have found that prolactin is unrelated to female androgenic pattern hair loss, despite earlier in vitro studies suggesting that it inhibited growth. Female patients with mineralocorticoid resistance present with androgenic alopecia. Older studies have found a slight relationship of prolactin with female androgenic hair loss.

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